Wellbeing: Hope for the future or an echo from the distant
past? Andrew Jahoda
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Hope for the future The happiest country
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No surprise!
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Wellbeing a new world view? Todays talk Look back at the
related concept of quality of life a shared sense of personhood? A
shift to wellbeing a new departure ( with reference to
psychological approaches)? Wellbeing and Quality of Life and people
with intellectual disabilities where have we got to? Wellbeings
relationship to current wider social trends beyond the field of
intellectual disability
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Wellbeing We arethe only species whose needs have a history. It
is the needs we have created for ourselves and the language of
entitlements we have derived from them, which give us any claim to
respect and dignity as species and individuals. Needs language,
therefore, is a distinctively historical and relative language of
the common good. (Michael Ignatieff, 1984; 14) Wellbeing: and the
language of need...
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Back to the future: Quality of Life and Intellectual
Disability? A small slice of history
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The Changing nature of Institutional care
EducationContainment
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Quality of life: what you deserve and what you want The key
change was how people with intellectual disabilities were seen as
persons. Not about professional breakthroughs. Few attempts were
made to compare their lives with the average person in the street
until people with intellectual disabilities were considered worthy
of leading more ordinary lives. Reflected wider changing social
trends and a greater acceptance of minority groups. The changes
need to be understood in this context.
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Objective Subjective Quality of life
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Quality of Life: Felce and Perry
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Back to the future: Quality of Life? David Felces model
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Back to the future: Quality of Life and Intellectual
Disability? People like David Felce and Robert Shalock and Robert
Cummings hugely influential in the field of Quality Of Life worked
with people who have intellectual disabilities Achieving a good
Q.O.L. for some of the most disadvantaged and marginalised in
society perhaps helps us think about about what a good quality of
life should like for us all
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Other efforts at measuring /quality of life Acceptance through
conformity Normalisation PASSING Recognition of difference /
diversity Person Centred Planning A new market place of support
services Quality inspection / regulatory framework
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Hope for the future: A new language of wellbeing A shift
towards (individual) Wellbeing: Satisfaction, happiness and
psychological approaches
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Hope for the future: wellbeing in relation to health health is
defined as a state of well- being in which every individual
realises his or her own potential, can cope with the normal
stresses of life, can work productively and fruitfully, and is able
to make a contribution to her or his community. (WHO)
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Wellbeing a shift to the individual Individual happiness and
fulfillment Positive psychology and other psychological approaches
to promote wellbeing Not an easy concept to measure or for a lot of
people to understand Martin Seligan
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Wellbeing happiness and positive psychology the challenges Is
feeling happy or satisfied always enough? he has no one to care for
him, only a girlfriend who exploits him to the best of her ability.
Given these circumstances, one would expect Richard to be
depressed, anxious, worried or at least discouraged with his
plight. He has little reason to be happy with the way things are,
but none the less, he is happy exactly the way they are. (Edgerton
ad Ward, 1991; pp. 148149)
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Wellbeing an active process: Extract from a case study Karen,
aged 19
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Karens background Lived at home with her mother and attended a
college course for people with intellectual disabilities. Diagnosed
with significant anxiety related problems and depression but her
outbursts with her mother brought her to the attention of services.
Had difficulty negotiating the move towards greater independence
and adulthood. *Permission to use materials part of video
produced
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A real choice? People dont always have the agency to make the
changes they want or to lead the lives they want to. Their sense of
wellbeing needs to be understood in the wider context of their
lives.
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A public health approach to health and wellbeing Stigma
Discrimination Harassed/bullied Violence & abuse Communication
of others Multiple life events Poverty Disability cause Hypoxia
Meningitis Encephalitis Foetal alcohol syndrome Head injury
HIV/intrauterine infection Social causes Down syndrome Fragile X
Many causes Impairments Understanding Problem solving Communication
Sensory Motor skills Delayed/atypical developments Family dynamics
Parental stress /mental illness Looked after Schooling
Limited/atypical social networks Social hierarchy identity
Exclusion Nutrition Sedentary Isolation Self efficacy Locus of
control
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Psychological approaches an end in themselves...? Psychological
Approaches (not unique to people with disabilities) MINDFULLNESS
ACCEPTANCE AND COMITTMENT CBTSELF-REGULATION
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Psychological approaches an end in themselves... Linked to the
idea of happiness and the view that particular psychological
approaches hold the key not just to overcoming problems but to
leading a good life Important to have equality of access to
psychological therapies BUT Does absence of distress or stress =
wellbeing?
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Wellbeing and psychological therapies a step forward? One
solution to problems? Whats works is complicated interventions can
be difficult to tease out Is it in professional interests to be
self-critical about the approaches to use? Can be especially
difficult if we are true believers of a particular approach. Once a
person is less anxious, more self-controlled or less stressed then
what? Therapeutic work should be the beginning rather than an end
point unless part of a new and chosen way of life
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Hope for the future: Promoting wellbeing and resilience
Building resilience The right support at the right time Dealing
with change and transition across the lifespan
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Wellbeing: Is the new terminology a sign of progress?
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Wellbeing: progress has been made No question that great
strides have been made in terms of the quality of life enjoyed by
many people But do people really have the quality of life that was
hoped for?
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Neighbourhood (Emerson et al, 2014)
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Civic and social participation (Emerson et al., 2014)
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Confidential Inquiry Women with intellectual disabilities died,
on average, 20 years earlier than women in the general population.
Men with intellectual disabilities 13 years earlier. 48.5% of
avoidable deaths amongst those with intellectual disabilities
compared with 24% avoidable deaths in the general population Hope
for the future: health inequalities
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Could do much better Hope for the future: hows it going
now?
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Wellbeing: Is it a sign of the times?
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Wellbeing linked to libertarian notions of personal
responsibility wellbeing a positive idea but welfare a dirty word
Risk of Double speak: austerity & wellbeing an uneasy
partnership (whatever Martin Seligman says) Money cant buy you
happiness, but it can buy the kind of misery you prefer (Unknown)
Money is better than poverty, if only for financial reasons (Woody
Allen) Wellbeing its relationship to wider social trends
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Another important health related trend: wellbeing and a focus
on genetics and the brain Enormously important work in
understanding the particular difficulties faced by people with
distinct difficulties, such as people with autism (brain picture)
Do we know what the specific gain is for people however we also
need to be clear about how this helps people to have a better
quality of life Also great individual differences that may be
overlooked Different solutions imaginative approaches etc Vital to
retain a focus on wellbeing and Quality of Life -progress is not
inevitable. Shocking abuses found in Winterbourne View Hospital run
by a private company in the UK Helpful to have a positive outlook
more than developing skills or reacting to problems Implicit idea
of choice and control - that people have an opportunity to develop
wellbeing UK research: 2007 - 2011 Work on biology, brain and
cognition makes up 53% of all autism research nationally Of more
than 100 UK funded autism research projects between 2007 and 2011,
only 21 explicitly included adults and just 11 focused specifically
on adult needs
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Back to the future: Wellbeing another step towards a real
Quality of Life? Are people always defined by their disability? A
real concern with individual differences Cultural differences and
finding imaginative approaches
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Back to the future: Wellbeing another step towards a real
Quality of Life? Are people always defined by their disability?
Areal concern with individual differences Cultural differences and
finding imaginative approaches
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Back to the future - wellbeing because I never got on at school
or anything like that. They found out that I was too slow. The
thing was, slow was frowned upon but its not really (sic) because I
may have been slow but I got there. Whats the matter about rushing
about on to reach the same target as the rest and then make
mistakes? Rushing can cause mistakes and disastersslow people get
there eventually. Whats the rush?
